Correlation between children and adolescents' behavioral habits and the occurrence of myopia in Qamdo
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摘要:
目的 了解西藏昌都地区儿童青少年近视现状及影响因素, 为高原地区青少年近视防控提供依据。 方法 随机抽取西藏昌都市一区两县的959名小学四年级至高中二年级学生进行视力、非散瞳屈光度检测和视力相关行为问卷调查, 分析近视发生情况及其影响因素。 结果 青少年近视率为54.43%, 屈光不正欠矫率为85.25%, 戴镜率为34.67%, 戴镜学生足矫率为42.54%。四至六年级学生近视率为35.14%, 七至九年级为64.71%, 十至十一年级为73.48%, 近视率随年级升高而增加(χ2=101.18, P＜0.01)。市区学生(四至九年级)近视率(70.40%)高于县城(41.45%), 父母任一方近视的学生近视率(68.24%)高于父母没有近视的学生(51.91%), 女生近视率(59.96%)高于男生(48.36%)(χ2值分别为53.19, 13.46, 12.98, P值均 < 0.01)。每天用电子产品时间≥2.5 h、夜间关灯后继续使用电子设备、晴天学习时光线不够明亮、晚上学习时仅用台灯或屋顶灯中的一种、过去7 d食用过油炸食品、睡眠质量差、早上起来仍感疲惫的学生近视风险更高(χ2值分别为10.35, 10.91, 6.87, 4.25, 4.97, 5.71, 12.11, P值均 < 0.05)。多因素Logistic回归分析显示, 近视的发生与地区、年级、性别、父母近视、过去5个月每天看电子产品的时间和睡眠质量相关(P值均 < 0.05)。 结论 西藏昌都市儿童青少年近视率较高, 可能与睡眠质量、电子产品使用时长、用眼环境、油炸食品进食频率有关。 Abstract:Objective To investigate the current status of myopia in children and adolescents in Qamdo, Tibet, and analyze related influencing factors, so as to provide a basis for the prevention and control of adolescents in plateau areas. Methods A cross-sectional study was conducted among 959 children and adolescents randomly selected from one district and two counties in Qamdo (from the fourth grade of elementary school to the second grade of high school) for visual acuity and refraction tests and filled out a vision-related behavior questionnaire to analyze the incidence of myopia among adolescents in the region and its associated factors. Results The myopia rate of adolescents in grades 4-11 was 54.43%, the rate of undercorrection of refractive errors was 85.25%, and the percentage of students wearing eyeglasses was 34.67%, fully vision correction rate was 42.54%. The myopia rate of students in grades 4-6 was 35.14%, 64.71% in grades 7-9, and 73.48% in grades 10-11. The myopia rate increased with grades(χ2=101.18, P < 0.01). The myopia rate (70.40%) of urban students (grades 4-9) was higher than that of county level(41.45%), and the myopia rate of students with myopia from either parent (68.24%) was higher than that of students without myopia (51.91%), the myopia rate of girls (59.96%) was higher than that of boys (48.36%)(χ2=53.19, 13.46, 12.98, P < 0.01). Use electronic products for more than 2.5 hours per day, electronic devices usage after bedtime, the light low indoor brightness when studying on a sunny day, and only use one of the table lamps or roof lights when studying at night, preference for fried food, poor sleep quality, in the morning the students who still feel tired are at higher risk of myopia(χ2=10.35, 10.91, 6.87, 4.25, 4.97, 5.71, 12.11, P < 0.05). Multivariate regression analysis showed that the occurrence of myopia was related to region, grade, gender, parental myopia, time spent on electronic products every day in the past 5 months, and sleep quality(P < 0.05). Conclusion The high rate of myopia in children and adolescents in Qamdo may be related to the quality of sleep, the length of time electronic products are used, the eye environment, and the frequency of eating fried foods. Outdoor activities do not show significant differences. -
Key words:
- Behavior /
- Habits /
- Myopia /
- Regression analysis /
- Child /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。2) 夏九一与杨鑫为并列第一作者。 -
表 1 昌都地区不同组别儿童青少年近视检出率比较
Table 1. Comparison of the detection rate of myopia among children and adolescents in different groups in Qamdo
组别 选项 人数 近视人数 χ2值 P值 地区 市区 223 157(70.40) 53.19 ＜0.01 县城 550 228(41.45) 年级 四至六 387 136(35.14) 101.18 ＜0.01 七至九 391 253(64.71) 十至十一 181 133(73.48) 性别 男 457 221(48.36) 12.98 ＜0.01 女 502 301(59.96) 父母近视 是 148 101(68.24) 13.46 ＜0.01 否 811 421(51.91) 注： ()内数字为检出率/%；市区中的人数剔除高中生186名。 
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表 2 昌都地区儿童青少年近视影响因素单因素分析
Table 2. Univariate analysis of associated factors of myopia amongchildren and adolescents in Qamdo
变量 人数 近视人数 χ2值 P值 过去5个月，每天看电子产品的时间/h ＜2.5 492 243(49.39) 10.35 ＜0.01 ≥2.5 467 279(59.74) 近5个月关灯后，是否继续看电子产品 是 724 416(57.46) 10.91 ＜0.01 否 235 106(45.11) 父母或老师是否提醒你的读写姿势正确 是 872 476(54.59) 0.09 0.76 否 87 46(52.87) 学习桌左侧是否有窗户，使得阳光可进入 是 718 397(55.29) 0.85 0.36 否 241 125(51.87) 晴天时学习桌桌面是否足够明亮 是 643 331(51.48) 6.87 0.01 否 316 191(60.44) 晚上学习时用什么灯光 同时使用台灯和屋顶灯 225 109(48.44) 4.25 0.04 使用台灯或屋顶灯 734 413(56.27) 晚上学习时是否觉得灯光足够明亮 是 818 446(54.52) 0.02 0.89 否 141 76(53.90) 学习桌和椅子高度是否适合身高 是 821 437(53.23) 3.33 0.07 否 138 85(61.59) 过去1周里，每天接触阳光时间/h ＜2 573 321(56.02) 1.45 0.23 ≥2 386 201(52.07) 过去7 d，是否吃过甜食 是 890 487(54.72) 0.41 0.52 否 69 35(50.72) 过去7 d，是否喝过含糖饮料 是 904 491(54.31) 0.09 0.77 否 55 31(56.36) 过去7 d，是否吃过油炸食品 是 827 462(55.86) 4.97 0.03 否 132 60(45.45) 睡眠质量是否良好 是 586 301(51.37) 5.71 0.02 否 373 221(59.25) 早上起来是否仍然感觉疲惫 是 425 258(60.71) 12.11 ＜0.01 否 534 264(49.44) 注： ()内数字为检出率/%。
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表 3 昌都地区儿童青少年近视影响因素多因素Logistic回归分析(n=959)
Table 3. Multivariate Logistic regression analysis of associated factors of myopia in children and adolescents in Qamdo(n=959)
自变量 β值 Wald χ2值 P值 OR值(OR值95%CI) 地区 市区 0.20 74.48 ＜0.01 5.50(3.73~8.09) 县城 1.00 年级 四至六 1.00 七至九 0.16 53.59 ＜0.01 3.31(2.40~4.56) 十至十一 0.24 3.15 0.08 1.54(0.96~2.49) 性别 男 1.00 女 0.15 16.92 ＜0.01 1.83(1.37~2.45) 父母近视 是 0.21 7.76 0.01 1.78(1.19~2.67) 否 1.00 过去5个月，每天看电子产品时间/h ＜2.5 1.00 ≥2.5 0.16 17.64 ＜0.01 1.96(1.43~2.68) 睡眠质量是否良好 是 1.00 否 0.16 4.77 0.03 1.40(1.04~1.90)
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